Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C1/00—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design
  • A61C1/08—Machine parts specially adapted for dentistry
  • A61C1/082—Positioning or guiding, e.g. of drills
  • A61C1/084—Positioning or guiding, e.g. of drills of implanting tools
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C13/00—Dental prostheses; Making same
  • A61C13/10—Fastening of artificial teeth to denture palates or the like
  • A61C13/1003—Fastening of artificial teeth to denture palates or the like by embedding in base material
  • A61C13/1013—Arch forms
  • A61C13/1016—Methods or apparatus for mounting, holding or positioning a set of teeth
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
  • A61B17/17—Guides or aligning means for drills, mills, pins or wires
  • A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
  • A61B17/176—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the jaw
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B2017/00526—Methods of manufacturing
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
  • A61C13/00—Dental prostheses; Making same
  • A61C13/0003—Making bridge-work, inlays, implants or the like
  • A61C13/0004—Computer-assisted sizing or machining of dental prostheses

Definitions

• the present invention relates to a method for producing an implant planting guide for planting an implant (artificial tooth root), and in particular, a method for producing an implant planting guide using a CAD / CAM system and its production.
• the present invention relates to a guide block used in the method.
• Implant (artificial root) treatment is widely used in the dental field. Implant placement position and orientation (planting position) to improve the functionality (engagement) and aesthetics of the artificial tooth to which the implant is attached and to maintain the implant stably in the jawbone It is important to correctly diagnose and design (angle) and perform treatment accurately based on that design.
• force CT imaging data is several hundred microns of poxel data, and when a metal fixed object is attached to the tooth, image distortion called metal artifacts occurs, and non-contrast properties such as resin If the prosthesis is made of any other material, the image will not be drawn, the range, depth, size, and shape of the drawn image will change depending on the CT value setting. Since the shape is simplified and the accuracy of the shape and dimensions is reduced, a highly accurate implant implantation guide that can be accurately positioned in the oral cavity based only on CT imaging data. There was a problem that it was difficult to create.
• Patent Document 1 Japanese Patent Laid-Open No. 2003-245289
• Patent Document 2 Japanese Patent Laid-Open No. 2001-170080
• the present invention has been made based on such a background, and a main object of the present invention is to provide a method for producing a highly accurate implant implantation guide for safer and more accurate treatment of implants.
• the present invention provides (1) a guide block including a mounting part that conforms to a patient's dentition and a processing part that is provided with a mark of a processing reference coordinate system necessary for processing. (2) Obtain CT image data of the patient with the above-mentioned guide block attached, and (3) Diagnose and decide on the three-dimensional image constructed based on the CT image data. Information on the planting position and planting direction (planting angle) of the guide is converted into coordinate information in the additional reference coordinate system of the guide block, and (4) the guide block is cut by a cutting machine Including the steps (1) to (4) above, wherein the guide block is cut so as to have a guide shape reflecting the coordinate information in the acquired processing reference coordinate system.
• the implant planting guide for CAD / CAM It is a manufacturing method.
• the mounting part is formed of a non-contrast material
• the processing part is formed of a contrast material! /.
• the present invention also includes (1) a guide base including a mounting part that fits a patient's dentition, and an imaging marker for identifying at least three points, and the guide base.
• (2) Obtain CT image data of the patient with the guide base attached, and (3) place the processing site on the guide base. Installed and integrated to create a guide block.
• (4) Diagnosis on the three-dimensional image constructed based on the CT image data. Determined implant placement position and orientation (planting angle) Information is converted into coordinate information in a processing reference coordinate system when processing the processing site via a coordinate system specified by the imaging marker, and (5) the guide block is cut Including the steps of (;!) To (5) above, wherein the guide block is set so as to have a guide shape reflecting the coordinate information in the obtained processing reference coordinate system.
• the present invention further relates to a guide block used in the above-described method for producing an implant placement guide, a mounting portion adapted to a patient's dentition, and a processing reference coordinate necessary for cutting. It is a guide block characterized by including a processing part provided with a system mark.
• the present invention is the guide block characterized in that the processing site is formed of a contrast-enhancing material.
• a guide block is prepared.
• the processing part that is milled (cut) into a predetermined shape in the process described later and the mounting part for mounting this processing part on the patient's dentition are integrated. Is.
• the mounting site is made of, for example, plaster taken directly from the patient's oral cavity, or created to fit the patient's dental model. In this case, it can be worn without slipping in the patient's mouth.
• a guide block is mounted in the patient's mouth, and in that state, CT imaging of the patient's mouth is performed to obtain CT image data.
• the obtained image data is a three-dimensional image including the patient's jawbone, dentition, and tooth defect site.
• the processing part of the guide block installed in the patient's mouth is also one. It is displayed at the beginning. In other words, it is image data that includes the raw data of the patient and the data of the guide block.
• the planting position of the implant is diagnosed and determined.
• the planting position and planting direction (planting angle) are specified as straight lines on the three-dimensional image, for example.
• the straight line representing the planting position and planting direction (planting angle) is data of the display coordinate system of the three-dimensional image.
• the guide block is processed based on the processing reference coordinates given to the processing portion of the guide block. Therefore, the data representing the planting position and planting direction (planting angle) determined on the 3D image is converted from the 3D image display coordinate system to the data of the machining reference coordinate system.
• the guide block is set in the cutting machine so that the planting position and planting direction (planting angle) of the implant converted into the data of the machining reference coordinate system are reflected, that is, Cutting is performed by the CAD / CAM system so that the guide shape reflects the data.
• the implant implantation guide formed by processing is a shape of an attachment site to be attached to the dentition 1S, for example, a shape obtained from a dentition model. For this reason, when the implant implantation guide is mounted in the patient's oral cavity, it fits perfectly with the patient's dentition. Therefore, the implant planting guide does not rattle in the oral cavity, and serves as a guide for forming a hole for implant implantation in the patient's oral cavity.
• the manufactured implant planting guide is in the patient's oral cavity. It ’s a shame! /
• implant planting guide can be correctly and accurately mounted in the oral cavity of the patient, appropriate treatment can be performed on the patient with reference to the guide.
• the guide block may not be an integral block, but may be a guide base and a guide block separated into processing sites.
• Guide block If the patient's mouth is small, or if the patient has a severe vomiting reflex, a CT block may be difficult to install with a guide block in the mouth. In such a case, it is desirable to use a guide block separated into a guide base and a processing part. This is because the guide base is a small and thin object including a mounting part and an imaging marker, and can reduce the burden on the patient during CT imaging.
• an imaging marker for specifying at least three points included in the guide base is used.
• the existing technique is used, and a three-dimensional CT image is obtained using a coordinate system defined by the three points.
• Data in the image display coordinate system can be converted to data in the machining reference coordinate system.
• the guide block of the present invention can be used well for patient implant surgery.
• the processing portion of the guide block is formed of a contrast material! /
• the implant placement guide is created.
• FIG. 1 is a view showing a method for producing an implant planting guide according to an embodiment of the present invention, and is a view showing a dental model of gypsum.
• FIG. 2 is a diagram showing a method for producing an implant planting guide according to an embodiment of the present invention, and is a perspective view showing an example of a processing portion 11.
• FIG. 3 is a diagram showing a method for producing an implant planting guide according to one embodiment of the present invention, and is a diagram for explaining a method for producing a guide block 10 from a dentition model.
• FIG. 4 is a diagram showing a method for producing an implant implantation guide according to an embodiment of the present invention, and is a diagram for explaining a process of obtaining CT image data.
• FIG. 5 is a diagram showing a method for producing an implant implantation guide according to an embodiment of the present invention, and is a diagram showing an example of a three-dimensional image based on obtained CT image data.
• FIG. 6 is a diagram showing a method for producing an implant planting guide according to an embodiment of the present invention. It is a figure for demonstrating the method of a coordinate transformation.
• FIG. 7 is a view showing a method for producing an implant planting guide according to an embodiment of the present invention, and is a view for explaining cutting processing of a guide block 10.
• FIG. 8 is a perspective view showing an example of an implant planting guide 100.
• FIG. 9 is a view for explaining another configuration example of the guide block 10 used in the method for producing an implant implantation guide according to one embodiment of the present invention.
• FIGS. 1 to 7 are views showing a method for producing an implant implantation guide according to one embodiment of the present invention.
• a dentition model of a patient undergoing implant treatment is prepared.
• the dentition model is produced by taking a mold in the patient's mouth using a conventionally known method, for example, plaster.
• FIG. 1 shows the prepared dentition model!
• the dentition model faithfully reproduces the lower dentition arranged in the patient's lower jaw.
• the dentition model shows an example in which the three teeth on the left back side are missing.
• dummy teeth DT1, DT2, and DT3 formed of contrast material may be placed in the defect site to reproduce the state in which the tooth at the defect site has been restored.
• the dummy teeth DT1, DT2, and DT3 are the force that reproduces the arrangement and size of the teeth provided at the defect site.
• the artificial tooth root (implant that supports the tooth) )is required. Therefore, the planting position and planting direction force of the implant necessary for the reproduced tooth are determined in the process described later.
• the step of placing dummy teeth in the missing part of the dentition model is not always necessary.
• the dummy teeth may not be arranged in the dentition model, and the process may proceed to the next step! /.
• the guide block 10 includes a processing part 11 and a mounting part 12.
• the processing portion 11 has a rectangular shape in plan view, a predetermined thickness (vertical width) h, and is formed of a contrast material (eg, aluminum, apatite, etc.). /!
• the processing part 1 1 is divided into, for example, one corner CO force and three sides orthogonal to each other, and these three sides define the X axis, the Y axis, and the Z axis in the processing part 1 1. This represents the machining reference coordinate system of the machining part 1 1! /
• a part for attaching the processing part 11 to the dentition model is the part 12 for attachment, and is made of a non-contrast material such as acrylic resin. (See Figure 3)
• the processing part 11 is positioned with respect to the dentition model.
• the processing part 11 is positioned in a substantially horizontal direction with respect to the dentition model so as to cover the upper part of the defect part.
• a gel-like acrylic resin is placed between the lower surface of the processing part 11 1 and the dentition model, more specifically inside the dentition. Fill and shape the acrylic resin.
• the filled acrylic resin is solidified with time and becomes a mounting portion 12.
• the solidified acrylic resin is bonded to the lower surface of the processing part 11 1 and integrated with the processing part 11 1.
• the solidified acrylic resin is not bonded to the dentition model, and can be removed from the dentition model with the force S.
• the solidified acrylic resin removed from the dentition model, that is, the mounting portion 12 has a mounting surface to which the uneven shape generated inside the dentition is completely transferred.
• the guide block 10 produced using the dental model is removed from the dental model after the acrylic resin 12 is cured.
• the guide block 10 can be easily removed by applying a stripping solution or the like to the dentition model in advance. Then, the removed guide block 10 is mounted in the patient's mouth.
• the mounting part 12 of the guide block 10 has a shape that matches the dentition model created based on the oral cavity of the patient, and in particular, the mounting surface of the mounting part 12 matches the irregularities inside the dentition. is doing. Therefore, the guide block 10 fits snugly in the patient's oral cavity.
• the guide block 10 is attached to the patient's oral cavity, and CT imaging is performed in this state to obtain CT image data.
• FIG. 5 is a diagram showing the three-dimensional image power of the oral cavity of the patient constructed based on the obtained CT image data.
• the three-dimensional image shown in FIG. 5 is displayed on a display of a computer system, can be rotated in a desired direction, and can display a cross-sectional shape of a desired part. Therefore, it is possible to diagnose and determine the optimum position and direction (angle) for implanting an implant on a three-dimensional image.
• the planting position and planting direction (planting angle) of the implant determined and determined on the three-dimensional image are data specified in the display coordinate system of the three-dimensional image.
• planting position and planting direction (planting angle) of an implant are specified on a three-dimensional image.
• the displayed three-dimensional image is displayed based on (X0, Y0, Z0) of the display coordinate system.
• ⁇ Al, bl, a2, b2, a3, b3 (or display coordinate system (X0, Y0, Z0)) are used to specify the implantation position and direction of the identified implant.
• a2 (x0a2, y0a2, z0a2)
• a3 (x0a3, y0a3, z0a3)
• the X axis, the Y axis, and the Z axis that pass through the corner CO and form the three sides of the processing portion 11 can also be specified using the three-dimensional display coordinate system (X0, Y0, Z0).
• (x, Y, z) (e coxo + co, ⁇ COYO + co, e cozo + co) can be expressed.
• ⁇ CO is the difference angle between X0 and X, Y0 and ⁇ , and ⁇ 0 and ⁇ .
• the implant setting position and setting direction (setting angle) and the corner C0 position of the processing part 11 of the guide block 10 and the direction of the processing part 11 can be specified as data in the display coordinate system of the 3D image.
• the data of the specified display coordinate system of the above three-dimensional image is used as the processing reference coordinates with reference to the corner C0 of the processing part 11 of the guide block 10 and the X, Y, and Z axes. Convert to system data.
• This conversion is performed as follows, for example.
• the position is on the 3D image display coordinate system.
• the guide block 10 is set in the cutting machine 50, and the fixing device After being positioned and fixed by 51, the guide block 10 is processed by the cutting device 52 into a shape for guiding the implant.
• the cutting device 52 is used for the guide.
• Block 10 is automatically cut into a shape that can correctly guide the implant. Note that the cutting process may be performed semi-automatically or semi-manually, or may be performed manually with reference to data.
• the guide block 10 becomes the implant placement guide 100.
• FIG. 8 shows an example of the implant placement guide 100.
• the implant planting guide 100 includes a U-shaped part I having a substantially U shape that covers the upper part of the dentition by processing the processing part 11, and guide grooves Gl, G2, G3 formed in the U-shaped part 11 ′, And a mounting part 12.
• Guide grooves Gl, G2, and G3 are grooves that are sized to guide the drill (drill shaft or bar), but instead of the groove that guides the drill (drill shaft or bar), the hand with the drill chucked is used.
• the head guide groove for guiding the head of the piece is larger than the groove guiding the drill).
• the implant planting guide 100 includes a mounting portion 12 that fits into a dentition formed of an acrylic resin. This mounting part 12 fits perfectly into the patient's dentition without gaps or looseness. Therefore, the implant placement guide 100 attached to the patient's dentition can correctly drill the hole for implant placement at the diagnosis' determined position of the patient's jawbone. In other words, by drilling according to the implant placement guide 100, the implant placement hole can be correctly and quickly drilled at the position and orientation determined. Then, it is possible to embed an implant at that position.
• the processing reference coordinate system of the processing portion 11 of the guide block 10 is determined by three sides including one corner CO and three straight lines orthogonal to each other.
• the processing reference coordinate system of the part 11 is not limited to such a method.
• the processing portion 11 is made of a material that can be displayed as a CT image at least three points that do not necessarily need to be made of a contrast material! /.
• the processing part 11 included in the guide block 10 is a processing reference in a three-dimensional image constructed based on the CT image data when the CT image is obtained as CT image data.
• Any configuration that displays at least three points required to create a plane or create a machining reference coordinate system is acceptable.
• the processing part 11 is composed of a non-contrast material as a whole, but only three points necessary for specifying the position of the processing part 11 are composed of a contrast material.
• Such a configuration or a form in which a straight line for creating a reference coordinate system for processing is drawn on the processing portion 11 with a contrast material may be used.
• the guide block 10 prepared for producing the implant placement guide has been described by taking the processing part 11 and the mounting part 12 as an integrated unit.
• the guide block 10 in this step may be in a state where the processing part 11 and the wearing part 12 are separated.
• FIG. 9 shows a configuration example of such a guide block 10.
• a guide base (resin floor) 12 serving as a mounting portion is mounted on a plaster dental model.
• the guide base 12 is made of, for example, an acrylic resin that is a non-contrast material, and an imaging force 114 including at least three spheres 111, 112, 113 is integrated.
• the three spheres 111, 112, and 113 have a contrast material for identifying their center points.
• the processing portion 12 may be the same as that described with reference to FIG. 2, for example, a rectangular shape in plan view, a predetermined thickness h, and a contrast-enhancing material (for example, aluminum, Etc.).
• a contrast-enhancing material for example, aluminum, Etc.
• the resin floor 12 shown in FIG. 9 can be used to reduce the burden on the patient during CT imaging. be able to.
• the imaging marker 114 including at least three spheres 111, 112, 113 is integrated with the resin floor 12, the existing technology is used to identify the three spheres 111, 112, 113 3
• the relationship between the marker coordinate system composed of two central points and the processing reference coordinate system assigned to the processing part 11 to be attached after imaging can be determined by a three-dimensional measuring instrument.
• a three-dimensional measuring instrument By converting the acquired implant placement position and orientation information on the CT image into the coordinate information of the processing part 11 in the guide block 10 via the obtained marker coordinate system.

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• Health & Medical Sciences (AREA)
• Oral & Maxillofacial Surgery (AREA)
• Dentistry (AREA)
• Life Sciences & Earth Sciences (AREA)
• Animal Behavior & Ethology (AREA)
• General Health & Medical Sciences (AREA)
• Public Health (AREA)
• Veterinary Medicine (AREA)
• Surgery (AREA)
• Epidemiology (AREA)
• Orthopedic Medicine & Surgery (AREA)
• Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
• Engineering & Computer Science (AREA)
• Biomedical Technology (AREA)
• Heart & Thoracic Surgery (AREA)
• Medical Informatics (AREA)
• Molecular Biology (AREA)
• Apparatus For Radiation Diagnosis (AREA)
• Dental Prosthetics (AREA)
• Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)

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Publications (1)

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Family Applications (1)

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Cited By (8)

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Citations (4)

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• 2006
  • 2006-09-25 JP JP2006259129A patent/JP2008073440A/ja active Pending
• 2007
  • 2007-08-15 WO PCT/JP2007/065909 patent/WO2008038471A1/ja active Application Filing
  • 2007-08-15 CA CA002664351A patent/CA2664351A1/en not_active Abandoned
  • 2007-08-15 US US12/311,245 patent/US20090274990A1/en not_active Abandoned
  • 2007-08-15 KR KR1020097005636A patent/KR20090069166A/ko not_active Application Discontinuation
  • 2007-08-15 EP EP07792543A patent/EP2072018A4/en not_active Withdrawn
  • 2007-08-15 CN CNA2007800347782A patent/CN101528153A/zh active Pending

Patent Citations (4)

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